Adult Granulosa Cell Tumor of the Testis: A case report and review of the literature.

Adult Granulosa Cell Tumor of the Testis (AGCTT) is a rare sex-cord stromal tumor. About 73 cases have been previously reported in the literature. We report a case of AGCTT in a 64 years old male, located in the left testis. We performed left radical inguinal orchiectomy. A sagittal section of orchiectomy specimen showed a solid yellowish-white mass measuring 1cm of long axis. On microscopic examination, we noted a well-limited tumor proliferation of solid architecture. The proliferation was made up of cells with scant cytoplasm and incised oval nuclei in a fibrous stroma. Rare Call-Exner bodies were noted.

Characteristics of Obstetric and Iatrogenic Urogenital Fistulas in Burkina Faso: A Cross-Sectional Study.

OBJECTIVE: To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. Material and Methods. We carried out a cross-sectional study over a seven years' period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups. RESULTS: 310 cases of UGF were included. IF accounted for 25.8% (n = 80) versus 74.2% (n = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05-3.1]), low level of education (OR = 5.4; CI = [2.3-12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7-6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1-4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1-20.5]). CONCLUSION: OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair.

Predictive factors for orchiectomy in adult's spermatic cord torsion: a case-control study.

BACKGROUND: Spermatic cord torsion (SCT) is a surgical emergency. Any delay in diagnosis or treatment may compromise the vital and functional prognosis of the testicle. The orchiectomy rate remains very high in the literature; it can even reach 50 % in certain series. Several factors have been reported in the literature as being significantly correlated with the risk of orchiectomy: duration of symptoms, the number of turns, the younger ages, etc. The objective of this study has been to analyse the predictive factors of orchiectomy in adult SCT in our context. RESULTS: During the study period, 74 cases of SCT were included. Orchidopexy was performed in 43.2 % (32/74) versus orchiectomy in 56.8 % (42/74) of cases. The patients' median age was 22 years (interquartile range (IQR) = 18-26.75 years). The duration of symptoms (p = 0.009), the previous medical management (p < 0.001), performing a scrotal ultrasonography (p = 0.004) were statistically significant at univariate analysis. On multivariate analysis only the previous medical management was statistically significant (p = 0.017). CONCLUSIONS: The orchiectomy rate was very high in our cohort. The previous medical management was the only significant predictive factor of orchiectomy on multivariate analysis. Our findings demonstrated that the delay in diagnosis is the determining factor in testicular loss in our context.

RéSUMé: CONTEXTE: La torsion du cordon spermatique est une urgence chirurgicale. Tout retard dans le diagnostic ou le traitement peut compromettre le pronostic vital et fonctionnel du testicule. Le taux d'orchidectomie reste très élevé dans la littérature;il peut même atteindre 50 % dans certaines séries. Plusieurs facteurs ont été rapportés dans la littérature comme étant significativement corrélés au risque d'orchidectomie. L'objectif de cette étude était d'analyser les facteurs prédictifs d'orchidectomie dans la torsion du cordon spermatique de l'adulte dans notre contexte. RéSULTATS: Durant la période d'étude 74 patients ont été inclus. Une orchidopexie a été réalisée dans 43,2 % (32/74) des cas et une orchidectomie dans 56,8 %(42/74) des cas. L'âge médian des patients était de 22 ans (écart interquartile=18-26,75 ans). La durée des symptômes (p = 0,009), la prise en charge médicale antérieure(p<0,001), la réalisation d'une échographie des bourses (p = 0,004) étaient significativement corrélées au risque d'orchidectomie à l'analyse univariée. A l'analyse multivariée, seule la prise en charge médicale antérieure était significativement corrélée au risque d'orchidectomie (p=0.017). CONCLUSION: Le taux d'orchidectomie était très élevé dans notre cohorte. La prise en charge médicale antérieure était le seul facteur prédictif significatif de l'orchidectomie à l'analyse multivariée. Nos résultats ont montré que le retard diagnostic est le facteur déterminant de la perte testiculaire dans notre contexte. MOTS CLéS: Torsion du cordon spermatique, Orchidectomie, Orchidopexie, Facteurs prédictifs, Urgence chirurgicale.

[Penile fracture: about six cases observed at the Souro Sanou University Hospital of Bobo-Dioulasso, Burkina Faso]. / La fracture de verge: à propos de six observations au CHU Sanou Souro de Bobo-Dioulasso, Burkina Faso.

Penile fracture is a rare urologic emergency, defined as a traumatic rupture of the tunica albuginea of the corpus cavernosum. It mainly affects the young subjects during sexual intercourse. The purpose of this study was to report treatment outcomes in 6 patients with penile fracture observed in the Department of Urology-Andrology, Souro Sanou University Hospital of Bobo-Dioulasso. The study involved six patients with an average age of 38.3 years admitted in the hospital with painful penile swelling (4 cases) and persistent urethrorragia (2 cases) after wrong coital movement or forced manipulation of the penis. Painful swelling of the penis with penis simulating the appearance of an aubergine was the main sign found. Treatment was based on evacuation of the intracavernous haematoma followed by albuginorraphy in 5 cases and conservative treatment in 1 case. All patients had an uneventful postoperative course.

Prostate Cancer Presenting with Parietal Bone Metastasis.

Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions.

High Prevalence of Opaline Silica in Urinary Stones From Burkina Faso.

OBJECTIVE: To underline peculiar composition of kidney stones and to propose an epidemiologic study of urinary stones in West African countries, where epidemiologic studies are scarce. Only few data are available regarding stone composition in sub-Saharan countries. Recently, a set of 100 stones consecutively removed by surgery in the Department of Urology of the University Hospital of Ouagadougou in Burkina Faso were collected for physical analysis, which provided the opportunity to obtain an epidemiologic profile of stone composition in this country. MATERIALS AND METHODS: A total of 100 stones from 64 men, 22 women, 10 boys, and four girls were analyzed by morphologic examination, infrared spectroscopy, and electron microscopy in our laboratory. The results were considered by sex and separately for adults and children. RESULTS: Sixty-five percent of the 100 stones contained calcium oxalate as the main component. Interestingly, the second main component was opaline silica (18%). Furthermore, opaline silica was identified in any proportion in 48% of the stones. The prevalence was sex and age dependent. Opaline silica was detected as the main component in 42% of the nuclei, which underlines its role as one of the main components involved in the initiation of calculi in this country. CONCLUSION: For the first time, a dramatically high occurrence of a "scarce" urinary stone component, namely opaline silica, was reported in a series of consecutive calculi from a single country. We propose that a regular consumption of clay could be the origin of this phenomenon in these populations.

Reconstructive surgery for giant penoscrotal elephantiasis: about one case.

Elephantiasis of the external genitalia is characterized by lymphedema and thickening of the subcutaneous tissues. This gives the skin an appearance similar to a pachyderm skin. This pathology is invalidating for the patient. Reconstructive surgery is often the only way to restaure aesthetic and functional aspects of the external genitalia. We aim to report a 52 year man with huge penoscrotal elephantiasis who underwent excision and penoscrotal reconstruction at the department of Urology, Yalgado Ouedraogo Teaching Hospital at Ouagadougou.

L'éléphantiasis des organes génitaux externes est caractérisé par un lymphodème et un épaississement des téguments responsable de l'aspect de peau de pachyderme. C'est une pathologie invalidante. La chirurgie de reconstruction constitue souvent la seule alternative pour restaurer l'aspect esthétique et fonctionnel de ces organes atteints. Nous rapportons un cas d'un volumineux éléphantiasis des organes génitaux externes chez un sujet de 52 ans qui a bénéficié avec succès d'une plastie péno scrotale dans le service d'urologie du CHU/YO.

Prostate cancer outcome in Burkina Faso.

INTRODUCTION: African-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC) diagnosis characteristics in Burkina Faso (West Africa). METHODS: We performed a prospective non randomized patient's cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE) result, serum prostate-specific antigen (PSA) level, histological characteristics and TNM classification were taking in account in this study. RESULTS: 166 transrectal prostate biopsies (TRPB) were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106). The mean age of the patients was 71, 5 years (52 to 86). Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59). Most patients, 56, 6 % (n = 60) had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58) had Gleason score equal or higher than 7. CONCLUSION: Prostate cancer is diagnosed at later stages in our country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.